Spirit of Christmas - Part 7
by Melissa Rivers
Summary: It's nearly Christmas in the ER and a few surprises abound


SPIRIT OF CHRISTMAS  
by Missy  
(missy@lexicon.net)  
  
DISCLAIMER: The characters of ER are the property of Michael  
Crichton, Warner Bros., Constant Productions and Amblin Television  
and the actors who so marvellously portray them.  
  
Any comments and/or constructive criticism will be gratefully received  
at the above e-mail address.  
  
PART 7/?  
  
  
"Everybody down and out of his way." yelled Mark . Those who hadn't  
been hit, fell to the ground or sought security from the shots in exam  
rooms away from his arc of fire.   
  
Mark went into Trauma One to contact security and the police from the  
extension. Silence temporarily reigned as he put down the phone.   
Chancing a look in the hall, he was relieved to find that the boy had run  
out of bullets from his two guns.   
  
As the boy tried to reload, he was tackled to the floor by one of the  
security guards, disarming him as two others stood by with their guns  
trained on him. Handcuffing him, they patted him down, discovering  
four more clips in his jacket. Jerking him to his feet, they took him   
down to their desk, away from the chaos that now existed in the  
waiting area and hallway.   
  
"How many victims have we got?" Mark immediately took control of the  
bedlam which now existed. Cries of pain emanating from victims, blood  
from gun shot wounds and flying glass splashed on the floor and across  
chairs and walls.   
  
Pulling herself upright carefully, wincing at the pain in her left leg, Kerry  
scanned the hallway. "Four GSWs in the hall" she reported noting the  
obvious entrance wounds on some of the bodies littering the hall in  
various positions.   
  
"Another three at least in the waiting area" Chuny said as she surveyed  
the mess of the waiting area. Shattered glass spilled over the seats and  
floor mixing with the blood of the victims. "That's without the  
superficial wounds from flying glass."  
  
"Carol, set up a triage." Mark ordered. "Call the blood bank, we're  
gonna need blood, lots of it."   
  
He surveyed the area, shaking his head in disbelief at all the people who  
had been either shot or injured from flying glass. However, he needed  
to maintain control, ensure that those who were injured received the best  
possible care that the ER could provide.   
  
Carol looked up from where she knelt beside Doug pressing on his  
abdomen, fingers of blood running over her hand. She didn't want to  
leave him but also knew she would not be able to treat him anyway due  
to her relationship to him. Carol knew from a theoretic point of view she  
would only be a hindrance but from an emotional one, she just wanted  
to be with him.   
  
"Go on Carol. We're going to need you out here. I'll take over." Carter  
said as he knelt beside her, snapping on the second latex glove on his  
hand. As she moved her hands from the site, Carter pressed down to  
also stem the bleeding. "Someone get me a gurney."   
  
"Love you." Doug slurred as he slipped his fingers brushed by her own.   
  
  
"I love you too." Carol whispered as her eyes brimmed with unshed  
tears. "Don't you dare leave me."  
  
"Not a chance. I would only haunt you anyway" Doug replied, his grin  
turning to a grimace as pain shot across his abdomen.   
  
"Carol, call dispatch and tell them we're closed to trauma." Kerry voice  
cut across the cries and bedlam beginning to reign. Shock was setting in  
with the victims and those who had managed to escape injury.   
"Where's Jerry and Randi? I need them to contact administration and  
arrange for surgical consults."   
  
Kerry shook her head. After Jerry's assurances following the chemical  
spill earlier in the year of being ready and fully organised in case of  
another emergency, she was disappointed that she was going to have to  
rely on the nursing staff to organise things. They really needed them to  
be treating patients, not making calls.  
  
The ER staff were in the process of organising themselves to treating the  
nearest victims to where they had dropped to avoid being hit by the  
rampaging teenager. Assessments were being made as to the severity of  
their injuries.  
  
"Please. Someone help me." Randi's distressed voice came from behind  
the admit desk,   
  
Kerry limped heavily in response to her call, finding Randi cradling  
Jerry's head in her lap with her hand pressed firmly on his chest, trying  
to stem the blood which continued to bubble from his chest and pool  
beside his broad body.  
  
"I've got another here. It's Jerry. I'm going to need Trauma One." Kerry  
called out to Mark. "Malik, get a gurney."   
  
Malik and Haleh grabbed the closest gurney, moving together they  
placed him on the trolley, rolling him straight into Trauma One.   
  
Randi was left looking at the blood still dripping from her fingers into  
the pool of blood across and around her legs, suffering from shock of  
having Jerry's life blood oozing over her hands, the big man pale against  
the crisp blue jacket he wore.  
  
"Carter, take Doug into Trauma Two. Maggie, put Lydia in Exam One.   
Anna, your patient to Exam 4......." Mark continued to direct patients to  
rooms, calling out for the patients that had been treated earlier to be  
discharged or moved into other areas of the hospital.   
  
Carol arranged for supplies to be restocked and patients to be triaged,  
their name tagged with particular colours according to their urgent need  
for treatment. She pushed aside her worry about Doug, using all her  
will power and energy into making the injured as comfortable as  
possible.  
  
"Randi, are you okay?" Carol asked concerned that the vivacious and  
seemingly unflappable clerk was still on the floor.   
  
"Umm. Yeah. I'm fine" Randi responded uncertainly, still absorbing  
the impact of the invasion by the teenager.  
  
"Get changed into a set of scrubs and I could do with a hand organising  
things out here." Carol instructed gently.   
  
The suggestion redirected Randi from her introspective state and  
recharged her, almost tangibly pulling herself back together to help Carol  
cope with the flurry of people to contact and organise.  
  
Carol started placing calls to administration advising them of the  
shooting, arranging for surgical consults and the OR to be ready to accept  
patients as soon as they had been stabilised.   
  
"This is Carol Hathaway from the ER. We have an emergency situation  
down here. We need surgical consults for seven GSWs."   
  
News that surgery was not at full capacity due to a shortage surgeons  
because of a seminar in Florida was not received well by Carol.   
  
"Well, you had better call in some! We have had our own staff members  
shot by a gunman as well as other patients." Carol continued holding as  
the surgical receptionist absorbed the urgency of their need and the  
disaster which had just occurred.  
  
- 0 0 0 -  
  
Chuny cut away Jerry's shirt and removed his tie allowing them access  
to the site of the gun shot wound. Kerry listened to the breath sounds,  
gauging the severity of the damage to his heart and lungs. It was not  
good.   
  
"I need an intubation tray. 7.5 ET tube." Kerry called out as she moved  
around Malik who was in the process of checking Jerry's blood pressure.   
  
Taking the laryngoscope and tube Haleh handed to her, Kerry deftly  
inserted the ET tube, checking his breathing once again to ensure that it  
was inserted correctly. Malik quickly attached the bag and commenced  
regular compressions on the bag.   
  
"Call radiology for a portable chest and a CT." Kerry instructed  
succinctly. She had noted the bruising to his head while inserting the ET  
tube. "Six of O neg. on the rapid infuser. Two of saline wide open.   
CBC, Chem 7 coag panel, H & H, blood gas, type and cross for eight."   
  
  
"BP's 65 over 40." Malik reported  
  
IV's were expertly inserted in response to the instructions. Chuny  
affixed the electrodes to Jerry's chest as Haleh brought up the cardiac  
monitor for connection.   
  
"Tachycardia"  
  
There were different possibilities for the cause of the tachycardia. Kerry  
noted that Jerry's neck veins are distended. Once again, she listened to  
his chest. "I can't hear any heart sounds."  
  
"Asystole." yelled Chuny as the cardiac monitor began beeping its  
warning. She immediately started compressions on Jerry's chest.   
  
"Let's crack him" called Weaver, her steady voice keeping control of the  
situation. They were all too aware that it was one of their friends on the  
table before them now, making them all vulnerable and feeling the life-  
blood draining from him. They doubled their efforts in a frantic attempt  
to keep a tenuous grip on his life.  
  
Haleh had anticipated this once Kerry had warned of the lack of heart  
sounds and already had the thorocotomy tray ready.  
  
"Number 10 blade" her hand ready to receive the scalpel.  
  
She made a horizontal incision extending from Jerry's breastbone across  
to his left armpit.  
  
"Rib spreaders."   
  
They were in her hands as she finished her words.  
  
"Two more units of O neg stat." As she spoke she inserted the device  
between two of his ribs, spreading them wide enough apart to enable her  
to get both of her hands into Jerry's chest cavity. Kerry could see  
Jerry's heart attempting to beat below his fingers. The pericardial sac  
around his heart was bulging with fluid.  
  
"What have we got?" Benton asked as he rushed into the room.  
  
"Pericardial tamponade." Kerry responded. She cut the sac with the  
scalpel and blood gushed out. "Give me some suction."   
  
Benton immediately suctioned out the area. There was still blood filling  
the sac. The bullet had damaged the heart. Kerry placed a cross clamp  
on the descending aorta. She placed her hand gently around the heart  
and located the source of the bleeding. Placing her finger over the  
bleeding hole Benton called for sutures and a needle. Working as a team  
with Benton, she sewed four large sutures into the wound. The blood  
has stopped leaking and Benton slowly released the clamps grip on the  
descending aorta.  
  
"I've got a pulse." called Chuny.  
  
"BP's 90 over 60" confirmed Haleh  
  
"Contact the OR and let them know we are bringing him up." Benton  
instructed.  
  
"Chuny, call the blood bank and have them send up eight units type  
specific to the OR." Kerry directed.  
  
"Everybody ready. Let's get him up." Benton said as the sides of  
the trolley were pulled up and they pushed Jerry out of the Trauma  
Room.  
  
- 0 0 0 -  
  
  
Mark passed the central work station and ducked his head in. "You've  
contacted surgery?"   
  
"Yep. They're calling in all their residents and on-call staff but it may  
take time for them to arrive." Randi replied, now dressed in green   
scrubs.  
  
"Mark, how's Doug?" Carol asked quietly.  
  
"I'm just heading there now. I'll let you know." Mark responded.   
"Here's the charts for the patients I've discharged. The DOH has called  
in their own staff to assist with the Ramesh family in quarantine."  
  
Mark handed Randi two other charts. "Can you arrange for John Carter  
and Emma Carides to be transferred to the cardiology. Tell them it's  
urgent."   
  
Walking through the hallway, glass crunched beneath his shoes.   
Housekeeping had begun the arduous task of cleaning up the mess but  
it was going to take quite a bit of work before the area was back to  
normal.   
  
Entering Trauma Two, Carter was just finishing inserting the  
endotracheal tube down Doug's throat.   
  
"How's he doing?"   
  
"Pulse ox is down to 86. BP's 75 over 50 and his cap refill is poor."   
Carter commented as he concentrated on listening to Doug's breath  
sounds following the insertion of the ET tube. "Portable chest."   
  
"Sinus tach is 150." Yosh put in.  
  
"CBC, Chem 7, H&H, ABG and coag panel, type and cross for six."  
Mark instructed.  
  
"Already done." Meredith informed him as she overheard his  
instructions, returning with the units of blood.   
  
"Dip the urine for blood." Mark finished.  
  
Carter proceeded to do the dip, getting a catheter. Mark checked the  
entrance wounds looking at the havoc the small missile had caused.   
Doug had managed to get shot not only once but twice, the bullets  
piercing the abdomen in the left lower region.   
  
"What've we got?" Elizabeth Corday asked as she breezed into Trauma  
Two, fully aware that the patient on the table could be someone she  
knew and she steeled herself for this possibility.  
  
"Doug. Two gunshot wounds to the left lower region."   
  
Elizabeth looked closely at the wounds. "Can we roll him?"   
  
Between the five of them, they gently rolled Doug on his side so that  
Elizabeth could determine if any of the bullets had exited. "Okay,  
we've got one exit wound. It looks like that's hit the spleen."  
  
"Dip is positive." Carter reported.  
  
"Let's get him up to the OR."   
  
Pulling up the sides of the gurney, IVs and blood hanging from the IV  
poles above Doug's head, his face pallid, they all took the trolley down  
to the lifts where Carter, Elizabeth and Meredith accompanied Doug to  
the surgical floor.  
  
- 0 0 0 -  
  
  
Carter exited the lift with Meredith, having returned from the surgical  
floor just as he saw Jerry being wheeled into the lift to go up.  
  
"How's Jerry?" he asked Kerry as they met outside the lifts.  
  
Kerry still wore the yellow protective clothing, the front of which was  
covered heavily in blood from her mid chest down to her knees. She  
stripped the gloves from her hands and tossed them into the hazardous  
material bin to the right of the lifts.   
  
"He's holding his own at this stage." she replied. "We had better all  
cross our fingers and just hope everything goes okay. How's Doug?"   
She continued stripping the protective clothing from about her body,  
the tapes catching on her crutch. As she bent over to release it, the  
room rolled before her eyes.  
  
"It looks like it was just a spleen." Carter replied. "Hey, Dr. Weaver.   
Are you okay?" Carter was concerned how the colour had suddenly  
drained from her face.  
  
"I'm not..........." Kerry began and then collapsed. Carter caught her  
before she hit the floor. It was only now that he noticed she was  
bleeding profusely from her left thigh. Checking the wound, he was  
alarmed to find it was from a gun shot wound.  
  
PART 7/? 


End file.
